Guide for Aviation Medical Examiners
Special Issuances

AME Assisted - All Classes
Paroxysmal Atrial Tachycardia and
Supraventricular Tachycardia

Examiners may re-issue an airman medical certificate under the provisions of an Authorization, if the applicant provides the following:

• An Authorization granted by the FAA;
• A statement regarding any recurrences since the last FAA medical examination; and
• The name and dosage of medication(s) used for treatment and/or prevention with comment regarding side effects.

• There have been one or more recurrences; or
• The applicant has received some treatment that was not reported in the past, such as radiofrequency ablation.

AME Assisted Special Issuance (AASI) is a process whereby the FAA delegates to AMEs the ability to re-issue an airman medical certificate under the provisions of an Authorization for Special Issuance of a Medical Certificate (Authorization) to an applicant who has a medical condition that is disqualifying under Title 14 of the Code of Federal Regulations (14 CFR) part 67.

A staff FAA physician provides the initial certification decision and grants the Authorization in accordance with 14 CFR § 67.401. The Authorization letter is accompanied by attachments that specify the information that treating physician(s) must provide for the re-issuance determination. If this is a first time issuance of an Authorization for the disease/condition, and the applicant has all of the requisite medical information necessary for a determination, the AME must defer and submit all of the documentation to the AMCD or RFS for the initial determination.

Note: Syncope (fainting), not satisfactorily explained or recurrent requires deferral (even though the syncope episode may be medically explained, an aeromedical certification decision may still be precluded). Syncope may involve cardiovascular, neurological, and psychiatric factors. AMEs will not immediately issue medical certificates if there are heart conditions that require deferral, or for any other cardiac condition that may result in sudden or subtle incapacitation. If the airman has one of these conditions, then the AME will consult with the FAA (AMCD) or the Regional Flight Surgeon. Medical documentation must be submitted for any of these cardiac conditions to support a possible waiver (special issuance) of an airman medical certificate.